Catholic health care is facing many of the same challenges confronting the Catholic Church as a whole, John Allen Jr. told members of the Catholic Health Association during the group’s annual meeting Nov. 3 at St. Patrick in Edina.

Allen, senior correspondent at National Catholic Reporter and a commentator for CNN, said religious freedom will be the greatest concern of the Catholic Church globally in the 21st century.

During his talk on “Religious Freedom and Catholic Hea­lth­­ Care,” Allen noted that, according to a report by one secular human rights organization: “There is an anti-Christian tide” around the world in which 80 percent of the religious freedom violations are against Christians, mostly in the Middle East, sub-Saharan Africa, the Indian subcontinent and China.

Oct. 31 marked the one-year anniversary of the attack by terrorists on Our Lady of Salvation Catholic Church in Baghdad, which left 53 dead and hundreds injured, he said. Although there had been many previous bombings of Catholic churches in Iraq, this attack was by terrorists who burst into the church and started shooting. In 1991, he said, there were 1 million Catholics in Iraq and now there are 250,000 or fewer.

Attacks legal, not lethal

“The U.S. situation is legal rather than lethal,” he said.

Attacks on religious freedom in the United States are more political, such as the health care mandates proposed by the Department Health and Human Services, he said. The agency’s interim final rule requires coverage of contraception and sterilization in most health insurance plans — practices that the church opposes.

That is a blow to Christian agencies that have long served people in poverty, migrant workers and trafficking victims. Without a broad religious exemption that protects Chris­tian agencies from violating their consciences, the mandates will push out religious health care groups or curtail the services they provide.

HHS also recently did not renew a grant with the U.S. bishops’ Migration and Refugee Services, ostensibly because the agency does not provide abortion and contraception to trafficking victims.

Religious freedom is facing a one-two punch, Allen said.

“We are living in a Catholic Church which is increasingly concerned with its Catholic identity and increasingly resistant to pressure from the outside world,” he said. At the same time, the outside world is less inclined to defer to religious authority or protect religious communities.

“I suggest to you that religious freedom is where those two forces collide,” he said.

Now and in the future, Catholic health groups will be facing new demands for global solidarity, more tension over “Catholic identity” in their facilities, and a variety of legal and political battles, Allen said.

However, because the church is becoming an “embattled subculture,” there are opportunities to “recalibrate relationships” with the bishops and with the broader public, he added.

As head of the U.S. Conference of Catholic Bishops, Archbishop Timothy Dolan of New York has had several confidential meetings with President Barack Obama to discuss the church’s concerns about the HHS mandates, Allen said.

“Our best hope is on getting Obama personally engaged,” he said. “He is the first U.S. president to be a former paid employee of the Catholic Church” through the organizing work he did with Catholic Charities in Chicago. The president is well-versed in the language of the church and good work it does, Allen added.

But the mandates are not just a Catholic issue. Other faith groups are affected, and everyone needs to let legislators know that this is a concern, he said.

Watch for ‘southern wave’

Allen also urged CHA members to keep in mind that the 60 million Catholics living in the U.S. make up just 6 percent of the total Catholic population.

“The global realities of the church . . . are increasingly going to set the leadership tone for the Catholic Church in the 21st century because that’s where our people are,” he said.

That global influence from the “southern wave” — which includes Asia, Africa and Latin America — was evident in the recently released document from the Pontifical Council for Justice and Peace on global economic reform, Allen said. The document calls for economic justice and was presented by Cardinal Peter Turkson of Ghana, who heads the council.

Allen’s book, “The Future Church: How Ten Trends are Revolutionizing the Catholic Church,” points out the disparities in global health care. Although poor countries account for 95 percent of the HIV/AIDS cases and 98 percent of the tuberculosis patients, only 5 percent of health care’s research and development is spent on those diseases, he reported.

As Medicare and Medicaid costs continue to rise and the workforce continues to decline in the U.S., Catholic health care groups will need to continue to create partnerships with other religious health care groups and seek support from their constituents.